Healthcare Provider Details

I. General information

NPI: 1639051741
Provider Name (Legal Business Name): NEXUS AT WOOD RIVER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 E EDWARDSVILLE RD
WOOD RIVER IL
62095-1646
US

IV. Provider business mailing address

5151 CHURCH ST
SKOKIE IL
60077-1123
US

V. Phone/Fax

Practice location:
  • Phone: 618-259-4111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: YEHUDA SUSSMAN
Title or Position: MANAGER
Credential:
Phone: 847-745-6946